Chapter 68: Pneumothorax Flashcards
Pneumothorax happen in patients with underlying lung disease
Secondary pneumothorax
Most common cause of secondary spontaneous pneumothorax
COPD
Caus of pneumothorax in HIV patient
Subpleural necrosis secondary to Pneumocystis infection
Common pathophysiology of primary pneumothorax
Subpleural bleb ruptures involving apex
What is tension pneumothorax
Develops as inhaled air accumulates in the pleural space but cannot exit due to a one-way valve system
Most common physical findings of pneumothorax
Sinus tachycardia
The clinical hallmarks of tension pneumothorax are
- Tracheal deviation
- Hyperresonance of the affected side
- Hypotension
- Profound dyspnea
If patient with pneumothorax is critically ill and cannot move. What sign will you look?
Deep sulcus sign
True or False
Compare to bullae, pneumothorax does not cross more than one lung segment
False
Pneumothoraces usually cross more than one lung segment, whereas bullae follow a single lobe
The British Thoracic Society defines a small pneumothorax as?
With a <2-cm rim between the lung edge and chest wall; a large pneumothorax is defined as one with a ≥2-cm rim
Normal sign seen in US of the lung
- Seashore
- Comet tail
- Sliding sign
Criteria for Stable Patient With Pneumothorax
- Normotensive
- HR 160-120 beats/min
- RR <24 breaths/min
- O2 sat of >90%
- No dyspnea at rest, speaks in full sentences
- Absent of hemothorax
Recommended oxygen dosing for pneumothorax?
3L/min to 10L/min
In observing a patient with a pneumothorax, when to reassess and repeat chest x-ray?
At least 4 hours and repeat chest xray
Needle decompression
To decompress, use a 14-gauge needle for adults at least 2 inches (5 cm) long to penetrate the pleural cavity
